Hai-Yen Sung

Reducing cigarette consumption in California: tobacco taxes vs an anti-smoking media campaign.

OBJECTIVES The purpose of this study was to examine the relative effects of taxation vs an anti-smoking media campaign on cigarette consumption in California. METHODS Quarterly cigarette sales data reported by the California State Board of Equalization between 1980 and 1992 were used to estimate a time-series model, adjusted for seasonal variations and time trends. RESULTS The estimated results show that sales of cigarettes were reduced by 819 million packs from the third quarter of 1990 through the fourth quarter of 1992 owing to an additional 25-cent state tax increase, while the anti-smoking media campaign reduced the cigarette sales by 232 million packs during the same period. CONCLUSIONS Both taxation and anti-smoking media campaigns are effective means of reducing cigarette consumption. The strength of those effects, however, is influenced by the magnitude of the taxes and the amount of media campaign expenditures.

Papanicolaou smear history and diagnosis of invasive cervical carcinoma among members of a large prepaid health plan.

Despite the widespread use of Papanicolaou (Pap) smear screening, substantial morbidity and mortality from cervical carcinoma continue in the U.S. Although access to screening is a major barrier to use of the Pap smear, invasive cervical carcinoma (ICC) still is observed in health plan members who have comprehensive preventive care coverage.

Do cigarette producers price-discriminate by state? An empirical analysis of local cigarette pricing and taxation.

This study analyzes the interactive effects of oligopoly pricing, state taxation, and anti-smoking regulations on retail cigarette prices by state, using panel data for the 50 US states between 1960 and 1990. The results indicate that cigarette producers do price-discriminate by state, though the effect is not large relative to the final retail price. There are two further results: (1) state taxes are more than passed on - a 1-cent state tax increase results in a price increase of 1.11 cents, and (2) sellers offset state and local anti-smoking laws with lower prices, thereby blunting effects of the regulations.

Validity study of the K6 scale as a measure of moderate mental distress based on mental health treatment need and utilization.

The widely‐used Kessler K6 non‐specific distress scale screens for severe mental illness defined as a K6 score ≥ 13, estimated to afflict about 6% of US adults. The K6, as currently used, fails to capture individuals struggling with more moderate mental distress that nonetheless warrants mental health intervention. The current study determined a cutoff criterion on the K6 scale indicative of moderate mental distress based on mental health treatment need and assessed the validity of this criterion by comparing participants with identified moderate and severe mental distress on relevant clinical, impairment, and risk behavior measures. Data were analyzed from 50,880 adult participants in the 2007 California Health Interview Survey. Receiver operating characteristic curve analysis identified K6 ≥ 5 as the optimal lower threshold cut‐point indicative of moderate mental distress. Based on the K6, 8.6% of California adults had serious mental distress and another 27.9% had moderate mental distress. Correlates of moderate and serious mental distress were similar. Respondents with moderate mental distress had rates of mental health care utilization, impairment, substance use and other risks lower than respondents with serious mental distress and greater than respondents with none/low mental distress. The findings support expanded use and analysis of the K6 scale in quantifying and examining correlates of mental distress at a moderate, yet still clinically relevant, level. Copyright

Changes in cervical cancer incidence after three decades of screening US women less than 30 years old

OBJECTIVE To examine incidence trends of invasive cervical carcinoma in US women less than 30 years old from 1973 to 1999 by histologic type. METHODS Incidence rates were obtained from the National Cancer Institutes Surveillance, Epidemiology and End Results (SEER) database and stratified by age and three histologic categories: all histologic types, squamous cell carcinoma, and adenocarcinoma. The estimated annual percent change was calculated by joinpoint regression to measure trends during the entire evaluation period and a recent subperiod (1985-1999). All statistical tests were two-sided. RESULTS Incidence rates of cervical carcinoma overall and squamous cell carcinoma specifically declined during 1973-1999, with estimated annual percent changes of -0.94% (95% confidence interval [CI] -1.47%, -0.41%) and -1.10% (95% CI -1.59%, -0.62%), respectively. Rates of adenocarcinoma increased (+2.90%; 95% CI 1.34%, 4.49%), though trends have been stable since 1990. All cancers were uncommon: the annual incidence per million women ranged from 8.0 to 14.3 for squamous cell carcinoma and from 0.7 to 2.7 for adenocarcinoma. For women younger than 20 years, no statistically significant changes were observed, but cancers were rare (0-3 per million women annually). CONCLUSIONS More investigation is necessary to clarify the contribution of screening to declines in the squamous cell carcinoma rate and to determine the etiology of adenocarcinoma rate increases over the last three decades in US women less than 30 years old. Because of the small number of actual observed cases, caution must be exercised in interpreting these trends.

Economic burden of smoking in China, 2000

Objective: To assess the health-related economic burden attributable to smoking in China for persons aged 35 and older. Methods: A prevalence-based, disease-specific approach was used to estimate the smoking attributable direct costs, indirect morbidity costs, and costs of premature deaths caused by smoking-related diseases. The primary data source was the 1998 China National Health Services Survey, which contains the smoking status, medical utilisation, and expenditures for 216 101 individuals. Results: The economic costs of smoking in 2000 amounted to

Economic costs attributable to smoking in China: update and an 8-year comparison, 2000–2008

5.0 billion (measured in 2000, US

Who is exposed to secondhand smoke? Self-reported and serum cotinine measured exposure in the U.S., 1999-2006.

) in total and

Economic cost of tobacco use in India, 2004

25.43 per smoker (⩾ age 35). The share of the economic costs was greater for men than women, and greater in rural areas than in urban areas. Of the

Advancing age and cervical cancer screening and prognosis

5.0 billion total costs, direct costs were